A Multicenter Study of Adherence to Best Practices and Application of Epilepsy Quality Metrics in a Pediatric Telemedicine Encounter. (August 2022)

• Record Type: Journal Article
• Authors: Joshi, Charuta N.; Miller, Joseph S.; Silveira, Lori J.; Nelson, Julie A.; Walleigh, Diana J.; Joshi, Sucheta M.; Patel, Anup D.
• Is Part Of: Journal of child neurology. Volume 37:Number 8/9(2022)
• Page Start: 744
• Page End: 748
• Publication Date: 2022-08
• Subjects: epilepsy -- quality metrics -- telemedicine; Nervous system -- Diseases -- Periodicals; 618.928
• DOI: 10.1177/08830738221099730
• Languages: English
• ISSNs: 0883-0738

Abstract

Objective: To assess Epilepsy Quality Metrics (EQM) and guideline implementation in new pediatric patients seen in telemedicine.Methods: Multicenter, cross sectional, retrospective analysis.Results: Patients were similar across 3 centers for age, gender, and insurance type. Eighty-one percent presented for spells. One hundred sixty patients with epilepsy formed the EQM cohort.Results: Seizures described: 95%; frequency: 67%, last seizure documented: 81%, epilepsy syndrome documented: 67%; epilepsy diagnosis: 77%, medications reviewed: 56%, adverse events discussed: 73%. Quality of life discussed: 3%. Anticipatory guidance was described as follows: seizure safety, 57%; driving, 47%; SUDEP, 11%; vitamin D discussion, 19%; pregnancy and folic acid counseling, 4% and 10%. Epileptologists were 4 times as likely as generalists in discussing driving safety (odds ratio 3.93, 95% confidence interval 1.7-8.9; P = .001) for all ages. Significance: Performance on EQM and guideline implementation in pediatric epilepsy telemedicine encounters can be improved.